Machane Pioneers 2025
Email *
Camper Last Name *
Camper First Name *
Mailing Address, Street and City *
Mailing Address, State *
Returning Camper? *
Parent 1 Full Name *
Parent 1 Email *
Parent 1 Cellphone *
Parent 2 Full Name *
Parent 2 Email *
Parent 2 Cellphone *
Emergency Contact Name and Contact Info *
Camper Age *
Camper Birthdate *
Camper Grade in the Fall of 2025 *
Camper School *
Reference 1 Name and Contact Info *
Reference 2 Name and Contact Info *
Camper Shirt Size *
Any behavioral or mental health issues/ADHD Diagnosis? *
Any significant life events we should be aware of? *
Any activity restrictions? *
Does your child have any dietary requirements outside of Kashrus? *
Does your child take medication/will take this summer? *
Does your child have a history of bedwetting? *
Does your child have a history of allergies? *
Does your child have a history of asthma? *
Does your child have a history of seizures? *
Does your child have a history of migraines? *
Tuition for the summer is $4,450 which includes the initial payment of $500 made at registration. The balance $3,950 can be paid in full at any time or in two payments of $1,975 due March 1, 2025 and April 1, 2025.
Payments can be made via zelle to machanepioneers@gmail.com or through the link below:

*Limited Scholarships available upon request 
*Gear/canteen costs not included
*Transportation will be provided to camp from New York for a fee of $250 round trip

Please follow this link to make your non-refundable $500 registration deposit. Acceptance will be confirmed via email. Make sure to include the camper's name in the note.
*
A copy of your responses will be emailed to .
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